Healthcare Provider Details

I. General information

NPI: 1306334222
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 07/31/2020
Certification Date: 07/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20151 NORDHOFF ST
CHATSWORTH CA
91311-6215
US

IV. Provider business mailing address

5555 FERGUSON DR
COMMERCE CA
90022-5164
US

V. Phone/Fax

Practice location:
  • Phone: 818-407-3200
  • Fax:
Mailing address:
  • Phone: 323-914-7365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: JENNIFER CHEN
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 818-637-3050